Body Dysmorphic Disorder

What is body dysmorphic disorder (BDD)?

Body dysmorphic disorder (BDD) is an anxiety disorder related to body image. If you have BDD you experience concerns about your appearance that cause you significant anxiety and have a disruptive effect on your life. You may also develop routines and habits, such as excessive use of mirrors or picking your skin, to deal with the worries you have about the way you look. These habits usually have a significant impact on your ability to carry on with your day-to-day life.

I see myself as completely disfigured and I am constantly trying to convince people of this.

It may also cause other problems such as:

  1. feelings of shame, guilt and loneliness
  2. isolating yourself to avoid situations that cause you anxiety or discomfort
  3. depression or anxiety
  4. misuse of alcohol or other drugs
  5. self-harm
  6. suicidal thoughts.

Many people with BDD do not seek help as they are worried that people will judge them or think they are vain. This means that many people are likely to experience BDD for a long time before seeking help.

People assume you are ‘vain’ but this is a serious life threatening illness.

What are the common signs of BDD?

If you have BDD, you have obsessions that cause you significant anxiety and may also develop compulsive behaviours, or routines, to deal with this. In this way BDD is closely related to obsessive-compulsive disorder (OCD). (See Understanding OCD.)

Although everyone has their own experience of BDD, there are some common signs.

Obsessive worries about the body

If you have BDD you will often spend several hours a day thinking negatively about your appearance. You may be concerned about one specific area of the body or you may be worried about several different areas.

Common areas of anxiety include:

  1. Facial features, such as the nose, eyes, hair, chin, skin or lips
  2. Particular areas of the body, such as the breasts or genitals
  3. Feeling that your body is unbalanced or lacking symmetry
  4. Feeling that one of your features is out of proportion to the rest of the body
  5. Feeling too fat or too skinny.

Some people with BDD also experience an eating problem but not all people with eating problems will have BDD. (See Understanding eating problems.)

Common compulsive behaviours

You may also develop compulsive behaviours and routines to deal with the anxiety you feel about your appearance.

Common compulsive behaviours include:

  1. Using heavy make-up when out in public
  2. Brushing or styling hair obsessively
  3. Obsessively checking your appearance in mirrors or avoiding them completely
  4. Changing your posture or wearing heavy clothes to disguise your shape
  5. Seeking constant reassurance about your appearance
  6. Checking yourself regularly by feeling your skin with your fingers, particularly around areas you dislike the appearance of
  7. Picking your skin to make it smooth
  8. Constantly comparing yourself with models in magazines or people in the street
  9. Seeking cosmetic surgery or having other types of medical treatment to change the area of concern
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